Mortality in dementia: Linking in the role of delirium

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2020
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Garcez, F. B.; Avelino-Silva, T. J.. Mortality in dementia: Linking in the role of delirium. In: . DIAGNOSIS AND MANAGEMENT IN DEMENTIA: THE NEUROSCIENCE OF DEMENTIA, VOLUME 1: ELSEVIER, 2020. p.61-72.
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Patients with dementia are more vulnerable to several hospital-associated hazards including infections, functional decline, and delirium. The last is defined as an acute disruption of the mental state characterized by inattention, cognitive impairment, and fluctuating symptoms. Conversely, preexisting cognitive impairment is one of the main risk factors for delirium, and when the two conditions coexist, they collectively are called delirium superimposed on dementia (DSD). The differentiation between dementia, delirium, and DSD can be challenging, and the most useful features in this process are inattention and impaired level of arousal. DSD has been shown to accentuate functional decline and accelerate dementia progression, modifying the expected trajectory of the disease. Moreover, evidence exists to suggest that DSD is a predictor of mortality in hospitalized patients with dementia. Recognizing the impact of DSD in patients with dementia is an indispensable step toward improving delirium detection and implementing effective preventive measures in this population. © 2020 Elsevier Inc. All rights reserved.
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Delirium, Delirium superimposed on dementia, Dementia, Mortality, Prognosis
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